Due to an severe injury, which I expect to last about 3-4 months, I am unable to perform any exercise that requires me to bear weight on my feet. That means squats, leg press, and DL are out.
Can someone recommend a routine to maintain my glutes, quads, and hamstrings? I don't care if I have to resort to machine/isolation exercises as obviously I am going to have to compromise for a while. Knee extenion and leg curls are obviously options, but I don't know how I'm going to hit the glutes. I don't have a GHR machine, though I do have a crappy roman chair-like apparatus.
guys, I thank you all for your responses, but squats, lunges, etc. are out, even with light weights. Both legs are injured so unilateral exercises are not an option. I need exercises that don't require me to bear weight on my feet.
So far, the only ones I can think of are leg extension, leg curl, and hyperextension. Any other suggestions would be appreciated.
The injury is tibialis posterior tendonosis (bilateral).
how bout some band work, like band pulls for your glutes, band deadlifts/backextensions, band hip thrusts. lemme know if you need any descriptions on how to do these exercises. they place no "weight" on your back and you can buy a single mini/light/reg band for under $30 at elitefts
Who diagnosed you with the tendonosis, and how did they differentiate the injury from tendonitis? If it is tendonosis and you have gone through the MRI's to make sure there aren't any tears, I wouldnt see why body weight exercises would be ruled out. If anything I think they would be beneficial to rehabilitation of the injury. Also, the band work sounds like it could be good as well.
Definately bring it up with the PT or ATC or doctor that you hopefully got diagnosed by and ask them specifically what you can do. Get second opinions if possible as well.
I diagnosed myself with tendonosis- all of the doctors I have been to actually say it's tendonitis, but they don't even know the difference between the two condition. I'm sure it's tendonosis because it's been going on for eight months with little improvement even though I stopped running a long time ago.
Body weight exercises are ruled out because they hurt. Even though it's only bodyweight, the act of pushing against the ground increases the force on that tendon far beyond what is normally encountered during standing and walking. The same thing applies to band training.
You could try bodyweight reverse hypers... maybe try bands or ankle weights for extra resistance. You could try seated goodmornings too; more of a back exercise but I'm sure you could find a position to hit the hams and glutes more.
I would highly recommend seeing an ATC, a PT with experience with athletes, or an ortho surgeon or doctor with experience with athletes on this matter. By self diagnosing yourself with tendonosis and limiting your workouts to that degree, you could be short changing yourself for no reason at all.
Just out of curiosity, what educational background do you have in recognition and evaluation of athletic related injuries? What signs and symptoms, besides the 8 month time frame make you believe it is tendonosis? Any previous rehabilitation done? And why such a great limitation on activity?
You said you stopped running a long time again, which I'm assuming was what initially caused the pain in your post. tib. If you have taken all that time off, it is time that you get back to working that area. Pain is expected, but a general guideline is to keep activities to a max of a 6/10 on a pain scale. Work eccentrics and slow paced repetitions initially to strengthen the tendon collagen and progress from there.
Also, I would personally disagree with the force being put on your tib. post. being greater during a bodyweight exercise, such a squats, than during standing or walking. And I don't see where band training is even going to put excess force as well. Could do TKEs, leg curls, ab- and adduction, leg extensions, and many more exercises with bands that wouldn't put any access force on your tib. post.
Since December I've been to four sports medicine physicians, three podiatrists, an orthopedic surgeon and two different PTs, all of who are experienced with athletes and all of who were unhelpful. They all diagnosed me with tendonitis and, like most doctors, they don't seem to appreciate the difference between tendonitis and tendonosis.
I can also say with a fair degree of certainty that I have tendonosis because I went on a three-week regimen of steroidal anti-inflammatory drugs, and they did absolutely nothing. If I had inflammation, the steroids should have relieved the pain rapidly.
I have no related educational background. I've just picked the knowledge on my own.
Beside the time frame and the fact that anti-inflammatories didn't work, the tendon's FRAGILITY leads me to suspect tendonosis. The injury is extremely easy to aggrovate. I don't have to come even close to running to make it flare up badly. In fact, I can't even walk without rigid orthotics to take the tension off the tendon.
Part of the reason for this is that my podiatrist, with whom I have since terminated my affiliation, immobilized the area in casts for six weeks. When I got the casts off, everything was so weak that I quickly aggrovated the injury when I tried to start walking again.
In the last two months I have been doing weight bearing exercises in the gym and, while they don't seem to hurt too badly, they produce residual aching that continues for hours or days after the workout, and I'm concerned that this may inhibit healing. So I have resolved to stop doing this for a while.
I would agree with this if not for the fact that I have gotten worse since I stopped running (due to the immobilization).
What I have found is that there is a very fine line between degeneration and regeneration. While I recognize the need for rehab, my fear is that I am crossing that line by doing weight-bearing exercise.
I am aware of the value of eccentrics for treating tendonosis, BUT it is next to impossible to administer such exercises to the tibialis posterior due to poor motor control. I just get a bunch of rapid "jumps".
[quote] Also, I would personally disagree with the force being put on your tib. post. being greater during a bodyweight exercise, such a squats, than during standing or walking. [quote]
Any time you apply force to the ground with your legs, as in during a squat, the ground applies force to your legs, and the post tib tendon bears this force and it will be much greater than during standing. I can actually feel the muscle fire more as I ascend.
You could be correct that I am restricting my activity too much, but this has been such a noxious injury that I am now just completely scared to death of it... I figured the reason it hasn't healed yet is because I keep aggrovating it by walking too much, lifting, etc. So my idea was to stop all that for a month and see if it doesn't feel better.
I agree with you that there are many physicians and allied health professionals who combine the tendonitis and tendonosis conditions together due to some of their similarities, especially if they work with general population. It is saddening to hear that it is the same with those you had your experience with. If you do go back to one, I would specifically bring up that you feel it could be tendonosis and not -itis and see what they have to say. If you would like definate confirmation, get an MRI done.
Rest is not going to help a tendonosis, it will irritate it. Activity will help though. The immobilization is not going to help your cause at all and you will have to rehab surrounding muscular tissues as well.
Here is a link to a website that may have some helpful information for you. I would focus mainly on the ideas within each stage of rehab and implement those. www.athletes.com/fun/drryan13.htm
Definately try to continue doing the eccentrics. The "jumping" of the muscle is normal, especially after a long duration of immobilization. Just start with lower resistance and concentrate on controlling the "jumping" movements and moving as the slow pace. If orthodics help you with walking, use them for body weight exercises as well. I really think that the body weight exercises would help you out greatly with rehab. If you still feel uncomfortable doing them and worry, start out with some of the rehab stuff on the website and then progress to the body weight.